Circumcision recommended to fight HIV
Staff and agencies
30 March, 2007
By ALEXANDER G. HIGGINS, Associated Press Writer Wed Mar 28, 5:54 PM ET
GENEVA - U.N. health agencies recommended Wednesday that heterosexual men undergo circumcision because of "compelling" evidence that it can reduce their chances of contracting HIV by up to 60 percent.
But World Health Organization and UNAIDS experts said men need to be aware that circumcision is only partial protection against the virus and must be used with other measures.
Studies suggest 5.7 million new cases of HIV infection and 3 million deaths over 20 years could be prevented by male circumcision in sub-Saharan Africa, the agencies said.
Otherwise, they could develop a false sense of security and engage in high-risk behaviors that could undermine the partial protection provided by male circumcision, the agencies said.
The recommendations were based on a meeting earlier this month in Montreux, Switzerland, where experts discussed three trials — in Kenya, Uganda and South Africa — that produced "strong evidence" of the risk reduction resulting from heterosexual male circumcision.
The agencies said much depends on the situation in a given country, and little general benefit will result in countries where the HIV epidemic is concentrated among sex workers, injecting drug users or men who have sex with men.
"It was therefore recommended that countries with high prevalence, generalized heterosexual HIV epidemics that currently have low rates of male circumcision consider urgently scaling up access to male circumcision services," the agencies said.
"The recommendations represent a significant step forward in HIV prevention," said Dr. Kevin De Cock, director of WHO‘s HIV/ AIDS department. "Countries with high rates of heterosexual HIV infection and low rates of male circumcision now have an additional intervention which can reduce the risk of HIV infection in heterosexual men."
Although the rate of circumcision varies considerably from country to country, globally an estimated 665 million men, or 30 percent of men in the world, are circumcised, the statement said.
Priority should be given to providing circumcision to age groups at highest risk of acquiring HIV because it will have the most immediate impact on the disease. But, it said, circumcising younger males also will have a public health impact over the longer term.
It gave no estimate how much providing the service would cost, but said more money would be needed, but that donors should regard it as "an important, evidence-based intervention."